[Feature Article] Korean Multiport Robotic Platform: Partial nephrectomy using Revo-i surgical system



Special article on the presentation session about Revo-i given in the Celebration Symposium of 40,000 Robotic Surgeries at Severance Hospital-Joint Symposium by the Urological Research Society ②

Partial nephrectomy using Revo-i surgical system (Jongsoo Lee, Yonsei University College of Medicine)

Revo-i robotic surgical system has many strengths. It is currently accumulating many clinical cases of surgery overseas, including Uzbekistan, as well as in South Korea and it is usable in many departments. Considering that robotic surgery learning has mostly been based on the da Vinci system, Revo-i system allows surgeons or nurses who have experience in use of the da Vinci system to quickly get used to it with no need for a specific adaptation period.

Revo-i system is composed of a Master Console, Operation Cart, and Vision Cart and also supports all the instruments required for urological surgeries. When it comes to the current installation status, more and more foreign countries as well as domestic hospitals are installing Revo-i. Indeed, surgeons from various countries are visiting Severance Hospital to see and learn about the Revo-i robotic surgery.

Revo-i system is currently being used in many surgery applications. Examples for clinical trials include prostatectomy and cholecystectomy performed by Severance Hospital. After its official launch in the market, hospitals installing the robot and the surgery cases in various departments have been increasing, which has led to the current record of more than 1200 cumulative cases of surgery globally.

The greatest strength of the Revo-i system is its cost-efficiency. It is competitive compared to da Vinci in terms of the system price itself and has reasonable maintenance and consumable costs, which is beneficial for hospitals in many ways including profitability.

The first clinical paper using the Revo-i system was published by Professor Koon Ho Rha in 2018 (BJU International; September 2018, Vol. 122 Issue 3, pp. 441-448). Since then, the Revo-i system has constantly improved and now demonstrates softer movements.

You can notice the improved image quality and movements when you see a video taken after its market launch compared to a clinical trial video. The most recent version features more enhanced movements and it has been used in urological surgeries without any significant discomfort or issues so far. To date, I have performed 15 cases of surgery using Revo-i, with most of them being partial nephrectomy.

I also prepared videos of the da Vinci Multiport system and Revo-i for comparison. By comparing the two videos, you can see that there is no significant inferior difference in terms of the instrument movements and colors.

When it comes to the extent to which the Revo-i system can be used, I think it can be applied to most of the areas in urology because it is capable of stably handling the largest vessels in the body. As an example, I brought a video of nephrectomy of a donator. Generally, people have a single renal artery but this donator had three right renal arteries, all of which had early branching.

To minimize the number of vascular anastomoses during kidney transplantation, I attempted to ligate the vessels at a proximal site rather than at early branching points. For this purpose, the vena cava needed to be completely dissected. By choosing Revo-i for this case, the surgery was successfully completed. More recently, off-clamp robotic partial nephrectomy has been safely completed with Revo-i. It's a surgery requiring the technique with fast and accurate movements.

Certain hospitals and countries are in need of this Korean developed robotic surgical system, Revo-i system. My subjective opinion is that replacing a foreign device with a domestic offers great value. I hope Revo-i will achieve growth to another level by implementing as much feedback and advice. In this way, it can enter a stable phase and keep developing and one day replace foreign robotic surgical devices.

(Chair) Professor Sung-Hyun Paick (Konkuk University School of Medicine): Though all of us know the economical benefits of the Revo-i system, I think it is important what performances it can show us. In that regard, I think today's lecture well showed the extent of its performances.

I personally have seen the great improvement of Revo-i compared to its previous version as well. Like the professors previously said, I also hope Revo-i, as a domestically developed robotic surgery system, will be improved to be even more useful for surgeons and surgeries and will constantly develop and grow.

Korean article : https://www.whosaeng.com/150444